Blog

Working with families, one of the most common conflicts that arises (and the one that often becomes the most heated) between teens and their parents is concerning electronic usage and social media. Teens today seem attached to their phones and tablets – texting their friends nonstop, constantly checking Facebook, Twitter, Instagram and Snapchat to see what they missed in the last 5 minutes, or watching hours of Netflix or YouTube videos. The electronic device is there on the dinner table, it prevents them from completing homework, it intervenes with family time and effective communication, and can even lead to increased anxiety and depression. In session, I am often looked to as a guru about what is appropriate. And the truth is that it varies from home to home and from teen to teen; however there are some common strategies that can be utilized – just adjusted to fit each unique individual or family. Here are some tips for parents on how to manage their teen’s electronic and social media use in a balanced way that is fair for both parties:

Create a schedule that includes restrictions, especially around meal and bed times. Restrictions can be for the amount of usage each day/week and also for the kind of usage (i.e.: video chatting versus watching Netflix for hours on end). Make sure you ask for input from your child. This helps them feel that they are contributing to the agreement and you can learn about their interests, priorities, and concerns.

Pay attention to your child’s response during and following electronic and social media use. This will determine if you need to decrease the amount of time or way they are using electronics and social media. It may be time to intervene with restrictions and with concern if you’re witnessing negative responses such as academic challenges, sleep disturbances, anger/aggression, depression, and anxiety.

Be a role model. Electronic and social media usage is often seen as a “this generation” problem. However, I can’t help but to point out that many adults have the same issues – whether it’s constantly checking emails or taking work calls or watching TV. This may not be as “generational” as we think and our children may be learning it from us. So it’s important for parents to remember that your kids are watching so model behavior that you want them to follow. They are more likely to adhere to your rules if they don’t view you as a hypocrite.

Suggest and plan other activities to create balance. Let’s face it, electronic and social media use is part of our children’s lives and is how they communicate, learn, and are entertained. You just want to make sure that they are also experiencing enriching off-screen activities as well. So plan a family game night or a play date or enroll them in a sport or activity.

Follow through with these recommendations and with the restrictions you have agreed upon. They can be adjusted later but if you don’t follow them, how can you expect your child to?

It is true that the controversy surrounding the use of technology can cause conflict between parent and child. That is why I think it’s important, as a teenager, to establish boundaries for yourself. Social media can easily become an unhealthy obsession, distracting yourself from tasks that should be your highest priority. Whether it is making snap chat stories to show all your friends what you’re up to or stepping away from your group to find Pokémon, it is very common for technology to take away your attention and awareness of your current surroundings. Social media is associated with a negative stigma. However, if utilized in the right way, teenagers are able to stay connected with friends as well as stay updated on current issues. Social media apps such as Twitter and now even Snapchat, have trending topics that allow teenagers to read current news articles after just once click. It’s important for our parents to know its benefits and importance. If you feel that you can make your own decisions and are frustrated with your parent’s attempt to monitor your use of technology, take it upon yourself to make changes and positively integrate a healthy amount of technology into your life. Here are some easy reminders that I have found some of us may forget from time to time.

Don’t have your phone, computer, or any type of electronic out while doing homework. You won’t be as easily distracted and you will understand the material faster and more thoroughly.

Take advantage of the time you have with your friends. There is no need to be on your phone when watching a movie or simply just catching up. It takes away the intimacy from the conversation and honestly, it can be a bit rude as well.

With work, homework, errands, and sports, it can be difficult to find a time when everyone in your family is together. In most cases, a time for family occurs at dinner. Enjoy the company and conversation of your family. There is no reason to try and text or tweet your friends when you have opportunity to join a personal conversation right in front of you.

You are not and should not be attached to your phone. If you think your phone will be a distraction then leave it in your bag, room, or somewhere out of reach. If it isn’t there, then it won’t be a problem.

Always keep in mind that your attention can only be on one thing at a time. If you choose to use your electronics while something else is occurring, you are missing out on what’s in front of you. So, put down your phone (even just for a little, I know you can do it!) and enjoy the company, conversation, and time with your friends and family.

Conclusion:

Remember, the electronic and social media debate can be resolved with time, patience, cooperation, and appropriate intervention.

As we talked about last time, Executive Functioning, or EF, involves 2 main areas of brain processing:

Inhibition of Responses: Impulse control/self-restraint (e.g., stopping yourself from making an inappropriate comment, or acting inappropriately)

Awareness: Awareness of own thoughts and emotions. Also, self-speech/internalized speech (e.g., thinking to yourself about how you are going to do something, or thinking to yourself about the consequences of doing something, before you do it)

These brain processes are the basis of many other types of executive functions, listed below, all of which assist us achieve goals, act in socially appropriate ways, and complete tasks:

Concentration

Working Memory: holds information long enough to be processed into short term, and then long term memory

Emotion Regulation: Ability to modulate emotions/emotional reactions

Planning

Problem Solving

Time Management

Self-Motivation/Self Initiative

Organization

So, what happens to EF when a youth is experiencing Attention Deficit Hyperactivity Disorder (ADHD)?

ADHD interferes with EF in a variety of ways, and each youth experiencing ADHD will experience EF difficulties specific to him/her (not every person will experience all possible EF difficulties).

Listed below are a few common EF issues which can occur with ADHD:

Trouble in regulating emotional reactions, and need for sensory input:

Youths with ADHD may react with a level of intensity that is out of proportion to the situation, having big emotional reactions to minor events. Others often feel baffled as to why the youth is reacting with such intensity. This can cause problems in developing and maintaining friendships, as peers may not want to play or socialize with him/her, due to feeling uncomfortable with their intense emotional reaction.

Another area of struggle is becoming over excited in fun situations (e.g., birthday parties, class trips, vacations, festivals, social outings/get togethers with friends, cannot fall asleep at sleepovers and keeps other kids awake). For example, in these situations, youths with ADHD may talk loudly, run or climb where not appropriate, have difficulty waiting their turn, talk excessively, and act impulsively in a variety of ways (e.g., screaming above and beyond the level of other youths, grabbing others’ things, jumping around more than their peers, running off, hanging all over other youths, acting silly and younger than their age).

Additionally, many youths with ADHD have a need for movement and sensory input (need for oral, motor, or auditory activity). For example, they may benefit from chewing gum, doodling, fidgeting with rings/stretch bracelets/paper clips/erasers/pencil grips, and having music on at a low volume in a nearby room while completing homework. Or, some children benefit from moving around while learning math facts or vocabulary definitions in various subjects (hula hooping, jumping on an indoor trampoline, walking on a treadmill or stepping on a stepper, only if they are of an appropriate age for this. Likewise, doing movement activities prior to starting homework, and movement breaks in between doing homework assignments or study blocks, assists them (e.g., trampoline, hula hooping, cartwheels, somersaults, swinging, tossing a heavier ball with someone, wall push-ups, chair push-ups, jumping jacks, jumping rope, etc.). They actually pay attention, and maintain effort and concentration better, if they are doing these types of movements/fidgeting and obtaining such sensory input, because their brain is seeking and needing such types of sensory and movement inputs.

Difficulty in self-starting and completing tasks (particularly non-preferred tasks), and following through with directions:

Youths with ADHD frequently have trouble with initiating non-preferred tasks on their own (homework, schoolwork, chores, showering, brushing teeth, brushing hair, projects, SAT/ACT prep, doing college applications, studying for driver’s license, etc.), without at least a few prompts. They often need multiple prompts to start these types of tasks.

Moreover, they have difficulty in continuing to put forth concentration and effort to finish a non-preferred task, and only partially finish non-preferred tasks. For example, they may start the chore of putting away their things, or emptying a dishwasher, and then become distracted by something and walk off/do something else, with the task only partly completed. Or, they may only partly finish class work/homework, with unfinished sentences, careless mistakes, and/or skipping of items.

While completing tasks, youths with ADHD frequently need prompts/reminders to stay focused, to complete the activity. This can occur even with activities they select to do, which require sustained effort and concentration (e.g., Scout badges and pins). Such behaviors can be frustrating and confusing for parents/extended family members, as youths with ADHD can start and maintain concentration/effort on preferred tasks for longer periods of time (e.g., Minecraft, Xbox/ phone/ devices, computer games, reading if reading is a preferred task, fantasy play).

Similarly, due to the inattention aspect of ADHD, many youths struggle with following through with directions, only finishing one part of a directive (e.g., only putting away half of a laundry basket of their clothes, only completing one part of a school assignment, partly packing their backpack).

Poor problem solving, difficulty in planning ahead, and difficulty in thinking ahead to the consequences of his/her actions:

Youths with ADHD often have quick, impulsive reactions/responses to situations that can be inappropriate. They frequently lack the ability to think ahead to the consequences of their verbal comments or actions, and to figure out more than one solution to a problem. When problems happen, brainstorming a few solutions, and figuring out the steps to solve the problem, is hard for them. For example, when having a disagreement with a

peer (s)/sibling(s)/adult, such youths can only figure out one way to deal with this situation, instead of thinking of 2 or 3 solutions; they then act impulsively on the only solution they identified, which may not be effective. Furthermore, they may not learn from mistakes/consequences initially, continuing to do the same negative behaviors, even with repeated consequences.

Another area of struggle involves planning ahead for projects, tests, taking the ACTs/SATS, driving, and applying for colleges; youths with ADHD have may have difficulty in preparing for/doing these tasks over time, waiting until shortly before the deadline to start. They then experience stress and feelings of being overwhelmed, resulting in avoidance, shutting down, crying, and/or yelling, as well as worsening of inattention and problem solving/ planning/ organizational issues.

Likewise, when faced with more challenging schoolwork/homework/projects/tests, or a challenging sports/social/recreational situation, they may become overloaded/frustrated/angry, and may give up easily, because they have trouble with figuring out an effective way to manage that situation.

Poor awareness of own emotions, poor perspective taking, and poor awareness of how one’s comments/actions/behaviors affect other people.

Due to lacking such awareness, youths with ADHD frequently do not realize how what they are saying and doing negatively affects others. For example, they often do not realize their loud voice volume, that they have made an inappropriate comment, their interrupting, the negative effect of their impulsive behaviors, and that they are talking excessively about a preferred topic without allowing others to talk.

Similarly, taking the perspective of others is a struggle for them, leading to difficulty in understanding why others feel a certain way in response to their comments/behaviors. Therefore, they may be confused as to why others are becoming frustrated/annoyed with them, OR they completely lack any awareness that others are becoming annoyed/frustrated with them. All of this can cause them to appear unempathethic, and to look like they do not care about how they treating others.

Moreover, children with ADHD may have difficulty figuring out, and understanding their own feelings, and trouble identifying and expressing their own emotional reactions to situations. Consequently, coping with, and working through, stressors and problems can be challenging for them.

Directly below are parts I, II, and III of the series that were written throughout the past year. Thank you so much for joining into our series on EF in ADHD, and take care,

This past week has been recognized as National Suicide Prevention Week with World Suicide Prevention Day taking place tomorrow, September 10th. Suicide affects millions of people each year – those who have attempted or successfully completed suicide and family members and loved ones who have lost someone to suicide. However, suicide continues to be a topic that is often avoided in conversation.

Suicide is the 10th leading cause of death in the United States, with one suicide occurring on average every 12.3 minutes. Suicide is the 2nd leading cause of death in the US among 15- to 24-year-olds. It is estimated that more than 1 million people attempt suicide each year and approximately 4.8 million individuals are survivors of suicide. Most individuals who attempt or commit suicide do not necessarily want to die; they want to end the intense pain they are experiencing. When suicidal thoughts and behaviors are detected early and are discussed and dealt with, lives and families can be saved.

Below are warning signs that may lead to suicidal thoughts and behaviors as well as ways to support someone experiencing them and how to find appropriate help:

Warning signs:

Talking about killing themselves or a preoccupation with death

Voicing that they are a burden to others

Researching methods of suicide or ways to gain materials they can use to harm themselves

Withdrawing from activities they typically enjoy and isolating from family and friends

Feelings of hopelessness and expressing that they have no reason to live

Acting recklessly or aggressively

Expressing that they feel trapped in a current situation or emotional/physical state

A change in sleeping patterns

Increased use of alcohol or drugs

Extreme mood swings

A sudden burst of happiness or calmness

Ways to support someone experiencing suicidal ideations:

Talk about it! This is difficult but expressing that you are concerned and asking them to talk about their suicidal thoughts will show them you care and will provide them with relief and support.

Listen when they talk. Provide supportive and non-judgmental responses.

Help them to stay safe by staying with them until professionals arrive or by removing any items they could hurt themselves with (ie: firearms, knives, ropes, etc.)

Ask them if they have a safety or support plan in place or if they would like to make one. These usually include family/friends/professionals they can contact in a situation like this or positive coping skills that help them manage their intense thoughts and moods or reasons that they can identify to continue living.

Contact emergency services. If you are unsure how severe someone’s thoughts and intentions of suicide are call 911, a local crisis center, or a suicide hotline (National: 1-800-273-8255; Local: 1-800-499-7455). Or take them to a local crisis center or to a hospital ER immediately. Let the professionals intervene and decide how to handle the situation.

Support them in finding appropriate treatment with a therapist and/or psychiatrist

Surround yourself with support as well; do not handle this situation alone

Remember, the first and best way to prevent suicide is to talk about it. The more suicide is talked about, the more awareness it brings so that suicidal thoughts and behaviors are recognized and dealt with appropriately in a supportive manner.

Thank you for your interest in this very important subject.

Katherine Lloyd, MA, LPC

PA Licensed Professional Counselor for Adolescents, Young Adults, and Families

As we talked about last time, Executive Functioning, or EF, involves 2 main areas of brain processing:

Inhibition of Responses: Impulse control/self-restraint (e.g., stopping yourself from making an inappropriate comment, or acting inappropriately)

Awareness: Awareness of own thoughts and emotions. Also self-speech/internalized speech (e.g., thinking to yourself about how you are going to do something, or thinking to yourself about the consequences of doing something, before you do it)

These brain processes are the foundation for many other types of executive functions, listed below, all of which assist us achieve goals, act in appropriate ways, and follow through with tasks:

Concentration

Working Memory: holds information long enough to be processed into short term, and then long term memory, for remembering information in the future

Emotion Regulation: Ability to regulate emotions/emotional reactions

Planning

Problem Solving

Time Management

Self-Motivation/Self Initiative

Organization

So, what happens to EF when a youth is experiencing Attention Deficit Hyperactivity Disorder (ADHD)?

ADHD disrupts EF in a variety of ways, and each youth experiencing ADHD will experience EF difficulties specific to him/her (not every person will experience all possible EF difficulties/disruptions).

Listed below are some common disruptions in EF which youths with ADHD experience:

1. Trouble with following more than one direction at a time, and in following through with multi-step directions: For example, when a youth is directed to get dressed, brush hair, and brush teeth, a child sees a book/toy/other item of interest on the way, and then starts reading or playing with toy in the middle of the floor, possibly while only half dressed.

Similarly, when asked to complete chores/responsibilities/tasks, they may need multiple prompts and reminders to stay on task and finish. And, they may leave several tasks partially unfinished.

Or, youths do not understand assignments/test instructions/projects with many steps, and become confused, anxious, and/or frustrated and angry with such tasks.

2. Easily distracted and difficulty remembering information: Due to the inattention and problems with working memory, youths with ADHD may often lose items, even favorite items, as well as forget where they have placed even prized possessions.

Likewise, they have trouble finding papers in their desk, binders, back pack, and folders. They may not be able to find assignments they have completed, or repeatedly forget to turn in an assignment to the teacher.

Additionally, a youth can miss information in a situation, and remember a situation in a way that it did not occur. He/she may then rigidly insist that a situation occurred in a way it did not, or that a person made a certain comment, which was never stated.

Furthermore, youths may miss directions/instructions and, therefore, complete tasks incorrectly, or become confused/stressed/anxious because they do not understand how to complete a task.

3. Poor Awareness/Understanding of Time, and Poor Time Management: Youths with ADHD often have no sense of time. They may overestimate how long a task will take, and, therefore, resist or argue about completing chores, responsibilities, and homework, stating “It will take forever, it will take too long.”

And, conversely, youths with ADHD also underestimate how long tasks will take; as a result, they may not leave enough time to complete projects or tests. Instead of spreading out bigger projects or studying over a length of time, they may wait until a day or two before, and then experience feelings of stress, anxiety, and being overwhelmed, because they do not have enough time to complete the project, or to study.

In addition, youths with ADHD often have difficulty being on time for school or other events, meeting deadlines, completing tests in the required amount of time, and completing tasks in a timely manner.

4. Excessive talking and Frequent Interrupting: Youths with ADHD often talk excessively, due to ADHD preventing the inhibition of responses; they could talk 5-10 minutes without pause, and others are not able to have a chance to talk.

Moreover, they often talk at length about a preferred topic, which may not be of interest to others. This is coupled with frequent interrupting of others, when others try to talk.

Such behaviors are frequently frustrating for peers, friends, and family members. And, due to ADHD interfering with their awareness, they often are not aware/do not realize others are becoming frustrated. Consequently, this leads to problems in making and keeping friends.

If you are a junior in HS with plans to continue onto college after graduation, figuring out which school is right for you, completing numerous applications, and making a final decision can be overwhelming. Here are some recommendations from Boston College sophomore and 2015 CB East graduate Adrianna Vernace that are sure to make this task less daunting.

Similar to your everyday schoolwork, it is most important to never fall behind with your college applications. The best way to do this is to do your research. I know – research, especially outside the school hours, may be the last thing you want to do, but you definitely have to make it a priority. There are so many schools out there, so before starting the process, it’s important to know what you like and what you don’t. When applying to schools, think about location, school size, distance from home, academic prestige, sports divisions, classes that match your intended major, and extracurricular activities.

If possible, I would also suggest visiting and touring schools that catch your interest. You don’t need to tour every single college before you apply, but sometimes it’s worth the visit. It’s possible that your dream school on paper is nothing like the dream school you had in mind when visiting, and it could also save you the $80 application fee. Having a clear mind of what type of school you want can really help you choose the school that is best for you and make the process a whole lot easier!

Once you have narrowed your search down to the names of colleges to which you want to apply, thoroughly research (yes, more research!) all the deadlines of all the supplemental materials each college requires. Each college requires different materials, tests, and recommendations and has their own unique set of deadlines. Make sure you organize your needed materials (résumé, letters of recommendation, common application essay, supplemental essays, test scores, etc.) with sufficient time before it is due. You never want a problem to arise the day before an application is due, so it’s important to have enough time, in case something unexpected occurs.

After all your applications are sent in (some early action, some regular decision), you have some time to relax before you need to make the choice. There is no need to worry too much at this point. Your applications are sent in and everything will end up working out. Another crucial note to remember is that you are the person that will be attending the school that you (and possibly others) choose. While opinions and feedback from your parents, counselors, and friends are important, never settle for choices that you don’t like. Just because most of your friends are going to a particular school, doesn’t mean you should do that as well. You want to pick a school where you can thrive comfortably and succeed for the next four years of your life. Your happiness and contentment at your future school will have a tremendous impact on how well you perform. Once the acceptances start coming in, if you have not already visited the campus, please do so. While some people do begin school without having toured the campus, I highly suggest that you make the trip. Visiting the campus and seeing real students in action can make the difference between accepting or declining your acceptance.

Remember to stay informed, stay organized, and stay positive. Everything will work out in the long run and all your hard work and dedication will be worth it. Good luck and remember that help is always available but only you can make the right decision!

We have all had that feeling of being totally overwhelmed in high school. It is difficult to manage classes, homework, activities, and our social lives – not to mention this is also the time that we have to start thinking about what comes next for us following graduation. Many questions arise and they don’t always have simple answers. How do I balance homework with all of my other obligations? What courses do I register for that will be the best fit for me? Do I take AP classes, and if so, how many? What colleges do I apply for and how do I complete all of these lengthy applications? If college isn’t the right fit for me, what are my options? Working through these anxieties, learning to manage multiple responsibilities, figuring out how to find balance, and developing confidence in decision making allows high school students to gain a tremendous amount of knowledge and life skills that will be beneficial in the long run. And I promise, you will be able to make it through high school. Here are some tips that were helpful for me at the time:

Choose classes that are right for you. Sometimes we feel pressured to take classes we are not ready for because we think it will look good on a college application or because our friends are taking those classes. Then we realize we are not interested in the material or the amount of homework is too much or the content is too difficult. Choose courses that are challenging but also manageable. It is more important to do well in a class than sign up for a course for the wrong reason.

Many students take multiple AP classes to boost their GPA or to appeal to colleges. These are not good enough reasons to take such classes. These classes encourage rigorous thinking, require thorough understanding to perform well on tests, and involve extreme dedication to completing the homework, papers, and projects that are assigned. Multiple these by the amount of AP classes you choose to take and the amount of work can easily become unmanageable. Sophomore year gives you the opportunity to slowly transition into to the AP teaching style. If you are interested, and it’s okay if you aren’t, I would suggest signing up for one AP class sophomore year. It will give you insight into what AP classes are like and will allow you to decide whether or not you want to take more. Before you register for AP classes, ensure that you are passionate and interested in the subject and are willing to devote your time into doing well in the class.

Organize your work by each class and acknowledge the assignments you have. Create a visual (a calendar or list) that maps out all your assignments. Creating a visual is extremely beneficial because it allows you to see the work you have for the remainder of the week and prevents you from waiting to the last minute. No matter how many times you have done it (trust me, I did it all the time) waiting until the night before to start a paper or study for a test adds an unnecessary amount of stress to the work you already have. Planning ahead doesn’t just allow you to organize your work; it prevents you from falling behind which is another important obstacle in managing your course load. Always stay up-to-date with your work. Never let projects or papers slip by you during the week. If you plan accordingly, the amount of work will be spread over a few weeks instead of a couple of days, relieving you from stress that would eventually follow.

Remain calm, (yeah a lot easier said than done, right?). From experience, freaking out is not the best thing to do. It wastes time and energy. Confide in your teachers or school counselors – that’s what they are there for. Talk to your parents. Hang out with friends, Take breaks as needed. Find out what helps you to feel calm and relaxed.

Remember – you are not alone. Chances are that others are feeling the same way you are. By reaching out and talking to your peers you will realize that many others are experiencing the same stresses and concerns. Support one another as this will provide the encouragement and confidence needed to accomplish your goals!

And finally, and maybe most importantly, stay positive, work hard, and don’t give up! Getting through these challenges will leave you feeling proud and more confident about yourself and your future.

June is recognized as National PTSD Awareness Month. The National Center for Posttraumatic Stress Disorder estimates that approximately 7 to 8 percent of the US population will have PTSD at some point in their lives with an estimated 8 million adults having PTSD in a given year. And this is just the reported number of individuals known to have a diagnosis of PTSD! Imagine how many undiagnosed individuals there are in the United States who are experiencing symptoms that are affecting their daily lives. Working with children and adults with PTSD, I wanted to share some information about the symptoms and treatment so more individuals and families can seek help following a trauma.

For a long time, it was believed that only soldiers returning from combat could develop PTSD. This is still a misconception among many people. Anyone can be diagnosed with PTSD if they have experienced a trauma where they were exposed to actual or threatened death, serious injury, or sexual violence. And this does not always mean direct exposure. As the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) indicates, in addition to someone directly experiencing a traumatic event, an individual can also develop PTSD if they witnessed the event, if they learned that the event happened to a close family member or friend, or if someone is repeatedly exposed and connected to the traumatic event such as first responders, police officers, etc.

It is important to remember that not everyone exposed to a traumatic event will develop PTSD. However, it’s crucial to understand what symptoms to look for that may indicate that someone needs additional support or professional help.

Symptoms of intrusion include: recurrent, involuntary distressing memories of the event; distressing dreams or nightmares; flashbacks when an individual feels or acts as if the event was reoccurring; and intense physical and psychological reactions if reminded of the event.

Symptoms of avoidance include: efforts to avoid people, places, conversations, activities, objects and situations that may remind them of the event or blocking out memories, thoughts, and feelings related to the trauma.

Symptoms that affect a person’s thoughts and moods include: an inability to remember the trauma entirely or parts of the event; negative beliefs about themselves, others, and the world; persistent, distorted thoughts about the cause or consequences of the event (this often leads to self-blame); negative emotions such as fear, anger, guilt, and shame; difficulty feeling positive emotions; feeling disconnected from others; and losing interest in activities once enjoyed.

These symptoms need to be present for more than one month in order to meet criteria for PTSD.

After reading the information above, I am sure it is easy to see how PTSD can go undetected. Often, individuals are misdiagnosed with a mood or anxiety disorder, especially if they are unaware that an event they have experienced could be identified as a trauma. Also, PTSD can often look differently in children than adults. Sometimes children’s behaviors may be viewed as oppositional, defiant, hyper, or anxious and exploring the possibility of trauma and PTSD is overlooked.

There are also varying types of PTSD. These include uncomplicated PTSD, co-morbid PTSD, and complex PTSD. For individuals that believe they or a loved one may have PTSD, it is recommended to meet with a professional for an evaluation to determine the type of PTSD and the best treatment option.

Types of treatments effective in helping those with PTSD include Cognitive Behavioral Therapy (CBT), Cognitive Processing Therapy (CPT), Prolonged Exposure (PE), Eye Movement Desensitization and Reprocessing (EMDR), Family Therapy, Group Therapy, and Medication. For children, Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is most effective and includes elements of cognitive-behavioral, attachment, humanistic, and family therapy.

PTSD can seriously impact a person’s life – how they feel about themselves, their relationships with others, their ability to work, and their outlook on the future. But there is hope in overcoming the traumatic event and enjoying life again when individuals are well-informed and receive the appropriate support and treatment individualized for them.

Thank you for taking the time to learn about the symptoms and treatment of PTSD. Feel free to email me at Katherine@psychologyandcounseling.com for more information about this blog or its content. Look for a blog by the Center for Psychology and Counseling’s summer intern Adrianna Vernace in July. She will be providing tips on how high school students can best manage high school coursework.

Until then,

Katherine Lloyd, MA, LPC

PA Licensed Professional Counselor for Adolescents, Young Adults, and Families

The nights are getting longer and the temperatures are dropping. Many of our thoughts are turning to turkey and pumpkin pies. Some of those thoughts, though, are dreading the inevitable tension of dealing with that relative at the family holiday gatherings. Just about all of us have that one family member who says something (or several somethings) every year that makes us cringe. Sometimes we consider just not inviting them to Thanksgiving dinner this year. “but they’re family,” we usually decide, so we gird ourselves and wait for the stuffing to hit the fan. Sound familiar? Here are some tips for making the most of your time together.

Remember what it means to be a family. It goes beyond guilt-driven invitations to a meal. The healthiest and happiest families strike a balance between accepting individuality and providing connection. Typically, we think about this balance as children become teenagers and young adults and start pushing their boundaries out into new areas. It doesn’t stop there, though. Certainly, like is a lot easier if you and your family members agree on the important issues in like – religion, politics, child-rearing, and which sports team is the best. Most families don’t have such a high degree of similarity. Find ways to show that connection to your outcast family member. It will help you and them feel more comfortable. We all just want to be accepted. This is harder than it sounds, of course, which brings me to:

Show unconditional positive regard. The famous Humanistic Psychologist Car Rogers stressed the importance that families who love and acceptance to one another with no strings attached. He believed that a lack of positive regard from our families was the largest contributor to mental illness. When we don’t experience positive regard, many of us seek attention in any other way we can get it. Frequently, that’s done by getting others riled up. Maybe by extolling the virtues of that fringe political candidate, by passive-aggressively judging the choices that the new parents are making, or by going on and on about how the harry Potter books were OK, but the movies were much better (this last one is the most dangerous in my house). Admittedly, it can be difficult to show positive regard for the family member who makes us anxious. One way to be successful is to focus on something positive or likeable about the person, and talk about that. Everybody has redeeming qualities or interests that are shared with other family members. If conversation focuses on those things, the others tend not to come up.

Try to understand their point of view. This doesn’t mean you have to agree or give up your own point of view. You don’t even really need to talk about it, thought that is a bonus. If you can see why your family member believes the seemingly ridiculous things they believe, it will help you be more accepting of them. It’s a rare person who holds a belief for the sole reason of ticking somebody else off. What life experiences has this person had that led them to this belief? How does this belief make sense from their point of view? If you can answer these questions honestly and without judgement, you’ll have made great strides in providing the connection and positive regard I mentioned earlier.

Getting along always sounds much easier than it really is. chances are, despite your best efforts, moments of tension and argument will arise. When this happens, one of the most important strategies to remember is to make sure you argue with the ides, not the person. It’s all too easy for a disagreement to escalate into insults, accusations of stupidity, and mashed potato-slinging. If you can stay focused on the topic, you might actually increase connections even while disagreeing. By doing this, I’ve had great discussion with family members who disagree with me on politics, gun control, and who was the best Batman (it’s Micheal Keaton, of course).

The struggle many family members face is moving from ostracizing the black sheep to accepting a unique family member is a fear to go first. We are sometimes trained to believe that whoever makes the first move toward civility has admitted that they are somehow “wrong.” Don’t fall into this trap. Nobody has to be “right” or “wrong,” just accepting of differences. If you can do that, your whole family may have more to be thankful for this year.

Check out January’s blog for the continuation of the executive functioning series.

Warm Wishes,
Matthew Mutchler, Ph.D

Pennsylvania licensed Marriage and Family therapist.

Specializing in working with couples, families and individuals working through life transitions, relationships and stress/anxiety.

Assistant Professor of Counseling Psychology at Delaware Valley University in Doylestown, PA.

As we talked about last time, Executive Functioning, or EF, involves 2 main areas of brain processing:

Inhibition of Responses: Impulse control/self-restraint (e.g., stopping yourself from making an inappropriate comment, or acting inappropriately)

Awareness: Awareness of own thoughts and emotions. Also self-speech/internalized speech (e.g., thinking to yourself about how you are going to do something, or thinking to yourself about the consequences of doing something, before you do it)

These brain processes are the basis of many other types of executive functions, listed below, all of which assist us achieve goals, act in socially appropriate ways, and complete tasks:

Concentration

Working Memory: holds information long enough to be processed into short term, and then long term memory

Emotion Regulation: Ability to regulate emotions/emotional reactions

Planning

Problem Solving

Time Management

Self-Motivation/Self Initiative

Organization

So, what happens to EF when a person is experiencing Attention Deficit Hyperactivity Disorder (ADHD)?

ADHD interferes with EF in a variety of ways, and each person experiencing ADHD will experience EF difficulties specific to him/her (not every person will experience all possible EF difficulties).

*Often making silly/careless mistakes, even when they actually know the information

*Difficulty showing the math work product when doing math problems

*Trouble adding details into their schoolwork and conversations

*Frequently only do the bare minimum of schoolwork/chores required, and work is of a lower work quality

ADHD disrupts the executive functions of organizing, planning, sequencing (prioritizing, doing things in order), and tracking (being able to follow what is going on– e.g., being able to follow what: a teacher is saying, what others are saying in a conversation, what is happening in a game with other kids).

Therefore, when given instructions/assignments/projects/tests with more than a couple of steps and parts, youths with ADHD may not be able to figure out the instructions or how to do the task and become overwhelmed/stressed/frustrated/ angry.

Even clothes/shoe shopping can become difficult and stressful, for they are looking at a lot of shoes or clothes in large area, and they do not have the executive functions to figure out which items to try on first, in which order. Rather, it looks like an overwhelming amount of items to try on, and they cannot figure out which items to try on first and how to order/sequence the shopping.

Similarly, when entering a social situation (e.g., birthday party, middle/high school orientation, family parties), with many people and a few activities going on at once, youths with ADHD may not be able to figure out where to go, with whom to talk with, or what to start first, and then what to do next, because they cannot order and sequence these events. As a result, they may freeze, look confused, and/or become stressed/irritated/overwhelmed.

Likewise, youths’ bags, binders/notebooks, desks, or personal areas are frequently messy, and when they complete schoolwork and chores, it is often completed in a disorganized/messy way.

ADHD leads to difficulty in learning social and conversation skills. Youths with ADHD have difficulty tracking/following social interactions. Consequently, they may miss information (what people are saying, facial expressions, body language such as crossed arms) when talking/interacting with others; as a result, they may misunderstand/misinterpret what is said to them, or they may not understand what is happening in games, play with others kids, or conversations with others. At times, they become angry and stressed re: their misperceptions.

Also, due to the executive functioning disruptions caused by ADHD, youths with ADHD do not learn social skills and conversation skills via natural observation/social interaction and social modeling with others as most children do, and they are frequently behind socially.

For example, youths with ADHD may have trouble knowing and explaining their own and others’ emotions, understanding why others react the way they do, and taking the perspective of others. Similarly, many youths with ADHD do not understand the way in which their words, voice tone, facial expressions, body language, choices, actions, and behaviors affect friends, family, and others in their world.

Likewise, the ability to do back and forth reciprocal conversation can lag behind. Instead, youths with ADHD often tend to just talk about their own interests a great deal, without realizing that others are becoming frustrated/annoyed by their lack of reciprocal conversation and constant, or excessive, talking.

Tune back in, at the end January, to learn more about ADHD and EF in children and teens.

Until January,
Leah Murphy, Psy.D

Licensed PA Psychologist

Center For Psychology & Counseling

Make sure to check out our post by Matthew Muchler about the Holidays coming in December.

EF is primarily proccessed in the Frontal Lobe of the brain, in the Pre-Frontal Cortex.

EF involves 2 main areas of brain processing:

Inhibition of Responses: Impulse control/self-restraint (e.g., stopping yourself from making an inappropriate comment, or acting inappropriately)

Awareness: Awareness of own thoughts and emotions. Also self-speech/internalized speech (e.g., thinking to yourself about how you are going to do something, or thinking to yourself about the consequences of doing something, before you do it)

These brain processes are the foundation for many other types of executive functions, listed below, all of which assist us achieve goals, act in appropriate ways, and follow through with tasks:

Concentration

Working Memory: holds information long enough to be processed into short term, and then long term memory

Emotion Regulation: Ability to regulate emotions/emotional reactions

Planning

Problem Solving

Time Management

Self-Motivation/Self Initiative

Organization

Without these types of EF processes, decisions are made quickly in the moment without thinking of the consequences, and it is very difficult to multi-task, complete even simple tasks, follow social conversations, and understand social cues: and, this is some of what can happen when ADHD disrupts Executive Functioning.
Check out September’s blog to learn more about how ADHD impacts EF.